ABOUT THE SPEAKER
John Amory - Male reproductive health expert
John Amory is leading research into novel options for male contraception, male infertility and hypergonadism.

Why you should listen

John Amory is is currently examining the potential of using inhibitors of testicular retinoic acid biosynthesis as reversible male contraceptives. He has published more than 130 peer-reviewed papers in the field of male reproduction and serves on the Advisory Board of the Male Contraception Initiative. He is currently Professor of Medicine and Section Head of General Internal Medicine at the University of Washington, where he works as an attending physician on the inpatient medicine wards and in the outpatient General Internal Medicine and Men's Health Clinics.

More profile about the speaker
John Amory | Speaker | TED.com
TEDMED 2017

John Amory: How a male contraceptive pill could work

约翰·埃默里 (John Amory): 男性避孕药会如何起效

Filmed:
1,124,721 views

男科专家埃默里正在研发创新性的男性避孕药,以给男性一个新的选择来承担避免意外怀孕的责任。他详细讲述了研发的科学角度——以及为什么世界需要一个男性避孕药。
- Male reproductive health expert
John Amory is leading research into novel options for male contraception, male infertility and hypergonadism. Full bio

Double-click the English transcript below to play the video.

00:12
When I tell people
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当我跟别人说
00:14
that I'm trying to develop发展
a contraceptive避孕的 pill for men男人,
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我正在尝试研发男性避孕药时,
00:18
the response响应 usually平时 varies变化
along沿 gender性别 lines线.
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对方的反应一般取决于性别。
00:23
Women妇女 say something like,
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女性会说,
00:25
"Fantastic奇妙. It's about time. When?"
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“太好了,是时候了。
什么时候(能研制出来)啊?”
00:28
(Laughter笑声)
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(笑)
00:29
Men男人 have one of two responses回复.
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男性一般会有两种反应。
00:31
They either love the idea理念,
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他们要么很喜欢这个想法,
00:34
or they look at me a little warily翼翼
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要么就会用警惕的眼神看着我,
00:36
and wonder奇迹 what exactly究竟
I have in store商店 for their testicles睾丸.
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在想我到底打算
对他们的睾丸做些什么。
00:39
(Laughter笑声)
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(笑)
00:42
So why does the world世界 need a male pill?
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那么,这个世界
为什么需要男性避孕药?
00:47
Well, what if I told you
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如果我告诉你
00:49
that of the six million百万 pregnancies怀孕
annually每年 in the United联合的 States状态,
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美国每年六百万的怀孕人口中,
00:53
three million百万 of them are unintended意外?
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有三百万都是意外怀孕的?
00:56
That's half.
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也就是一半。
00:57
That's a really surprising奇怪 number.
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这是一个很让人惊讶的数字。
01:00
And those three million百万
unintended意外 pregnancies怀孕
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而这三百万计划之外的怀孕
01:02
account帐户 for the vast广大 majority多数
of the more than one million百万 abortions人工流产
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很大程度导致了美国每年
01:06
annually每年 performed执行 in the United联合的 States状态.
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一百多万次的堕胎。
令人欣慰的是,最近一些年
意外怀孕的比例
01:09
Happily令人高兴的是, the rate of unintended意外 pregnancy怀孕
has fallen堕落 in the last few少数 years年份
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01:13
by about 10 percent百分.
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已下降了 10% 左右。
01:15
This is because more women妇女
are using运用 effective有效, long-acting长效,
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这是因为更多的女性
在使用有效、长效、
01:18
reversible可逆 forms形式 of contraception避孕.
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可恢复的避孕方式。
01:21
But we still have a long way to go.
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但我们还有很长的路要走。
01:25
One approach途径 that's finally最后
becoming变得 a real真实 possibility可能性
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一种即将成为现实的办法
01:28
is better contraceptive避孕的 options选项 for men男人.
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是针对男性的更好的避孕措施。
01:32
Think about it.
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想想吧。
01:33
We have over a dozen methods方法
of contraception避孕 for women妇女:
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我们有数十种女性避孕手段:
01:37
pills, patches补丁, IUDsIUDs,
shots镜头, sponges海绵, rings戒指, etc等等.
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避孕药、避孕贴、节育环、
避孕针、避孕海绵、阴道环等等。
01:44
For men男人, we've我们已经 had the same相同 two options选项
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可对于男性,我们一百多年来
01:48
for more than a hundred years年份:
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都只有两种选择:
避孕套和输精管结扎术。
01:49
condoms避孕套 and vasectomy输精管结扎术.
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01:52
Despite尽管 having only two options选项,
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尽管只有两种选择,
01:54
both of which哪一个 have significant重大 drawbacks缺点,
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且两者都有重大缺陷,
01:57
men男人 currently目前 account帐户
for 30 percent百分 of all contraceptive避孕的 use,
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在所有使用避孕措施的人群中,
男性目前占了 30%,
02:02
with 10 percent百分 of couples情侣
relying依托 on vasectomy输精管结扎术
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其中 10% 的伴侣用的是结扎术,
02:04
and 20 percent百分 of couples情侣 using运用 condoms避孕套.
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20% 用的是避孕套。
02:08
Why are 20 percent百分 of couples情侣
relying依托 on condoms避孕套 for contraception避孕
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为什么 20% 的情侣会
依赖避孕套来避免怀孕,
02:13
when condoms避孕套 have a one-year一年
failure失败 rate of over 15 percent百分?
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尽管避孕套一年内的
失败率超过了 15% ?
02:17
It's because many许多 women妇女
can't either safely安然 take
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这是因为很多女性
要么由于血液凝结等原因,
02:21
currently目前 available可得到 female contraceptives避孕药,
for reasons原因 such这样 as blood血液 clots血块,
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无法安全的使用
目前提供的女性避孕措施,
02:24
or they can't tolerate容忍 the side effects效果.
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要么是因为她们无法承受副作用。
02:28
So if we think a male contraceptive避孕的
would be useful有用, the next下一个 question is:
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那么如果我们觉得让男性避孕
会很有效,那下一个问题就是:
02:32
How do we go about developing发展 one?
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我们该如何研发出
这样一种措施呢?
02:35
Well, there's two general一般 approaches方法.
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有两种大体的方向:
02:37
The first approach途径 is to try and interfere干扰
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第一种办法是尝试干扰
02:39
with the way the sperm精子
swim游泳 towards or bind捆绑 to the egg.
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精子移动并与卵子结合的方式。
02:44
This approach途径 turns out
to be really difficult,
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事实上这个办法难度相当高,
02:47
because it's hard to get enough足够 medication药物治疗
in the small volume of the ejaculate射出
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因为射出的精液容量很小,
很难让足量的药物溶在里面,
02:51
and have it still work inside
the female reproductive生殖 tract管道.
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并且还能在女性的生殖道里工作。
02:55
This is why there's been a lot more work
doneDONE on the second第二 approach途径,
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这就是为什么更多的研究
集中在第二种方式:
02:59
which哪一个 is turning车削 off
sperm精子 production生产 entirely完全.
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即直接停止精子的产生。
03:03
This is also challenging具有挑战性的.
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不过这个方法也很有挑战性。
03:05
Why? Turns out
that men男人 make a lot of sperm精子.
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为什么?因为你会发现
男性能生产很多精子。
03:09
(Laughter笑声)
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(笑)
03:10
Men男人 make a thousand sperm精子 every一切 second第二
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每秒中,男性可生产出一千个精子,
03:15
and to have an effective有效 contraceptive避孕的,
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所以有效的避孕药
03:17
you need to get that level水平
of sperm精子 production生产
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必须把这个精子生产率
降到正常值的1%。
03:19
down to one percent百分 of its normal正常 value.
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03:23
The good news新闻 is, this is possible可能,
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好消息是,这是可以做到的,
03:26
almost几乎.
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几乎可以。
03:27
The most studied研究 approach途径 has been to use
hormones激素 to suppress压制 sperm精子 production生产.
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被研究最多的方法是
用激素抑制精子生产。
03:33
Testosterone睾酮 and progesterone黄体激素,
when administered管理 together一起,
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睾丸酮和黄体酮,
当一起被服用的时候,
03:37
will suppress压制 the signals信号 from the brain
to the testes睾丸 to make sperm精子,
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会抑制大脑发射的
让睾丸生产精子的信号。
03:41
and in about 90 percent百分 of men男人,
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在 90% 左右的男性中,
03:43
sperm精子 production生产 after
three to four months个月 will stop.
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这个方法能使精子的产生
在三四个月后停止。
03:47
Unfortunately不幸, 10 percent百分 of men男人
don't respond响应 to these hormonal激素 regimens方案
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不过很遗憾,还有 10% 的男性
不会对这些激素疗法做出反应,
03:51
for reasons原因 that aren't understood了解.
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原因我们目前还不了解。
03:54
For the last several一些 years年份,
my colleagues同事 and I
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过去几年里,我和我的同事
03:57
have been taking服用 a different不同 approach途径
to male contraceptive避孕的 development发展,
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采用了另一种解决男性
避孕问题的方法,
04:00
one that doesn't involve涉及
the administration行政 of hormones激素.
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一个不需要激素疗程的方法。
04:04
Specifically特别, we are looking to block
the function功能 of vitamin维他命 A in the testes睾丸.
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具体来说,我们在研究如何
阻止睾丸中维生素A的活动。
04:09
Why? Well, for over 90 years年份
it's been known已知
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为什么这么做呢?90 多年来,
我们一直都知道
04:12
that you need vitamin维他命 A to make sperm精子.
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你需要维生素A来生产精子。
04:15
Animals动物 who are deprived剥夺
of vitamin维他命 A in their diet饮食
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饮食中缺乏维生素A的动物
04:19
stop making制造 sperm精子
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会停止生产精子,
04:20
and restart重新开始 making制造 sperm精子 again
when the vitamin维他命 A is reintroduced重新.
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当维生素A被重新引进饮食后,
它们又会重新开始精子的生产。
04:25
The vitamin维他命 A that we ingest摄取
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我们摄入的维生素A
04:28
is converted转换 by a family家庭 of enzymes
to something called retinoic甲酸 acid.
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会被一个类别的酶转化成视黄酸。
04:33
One of these enzymes
is found发现 only in the testes睾丸.
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其中一种酶只在睾丸才有。
04:37
It's this enzyme
that we are attempting尝试 to block.
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我们试图限制的就是这种酶。
04:40
The blockade封锁 of this enzyme
should deprive剥夺 the testes睾丸 of retinoic甲酸 acid
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阻断这个酶应该可以
使精子丧失视黄酸,
04:44
and stop sperm精子 production生产
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从而停止精子生产,
04:46
without affecting影响 vitamin维他命 A's functions功能
elsewhere别处 in the body身体.
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同时并不影响维生素A
在身体其他部分的功能。
04:50
We're testing测试 this approach途径 in animals动物
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我们正在动物体内测试这个方法,
04:52
and hope希望 to move移动 to human人的 testing测试 soon不久.
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希望不久后可以在人体内测试。
04:57
Obviously明显, the impact碰撞
of such这样 a male contraceptive避孕的
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当然了,这样的男性避孕药
05:00
would go well beyond reproductive生殖 biology生物学.
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影响的肯定不只是生殖生物学。
05:03
It's interesting有趣 to speculate推测
about the effect影响 that it would have
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它会如何影响男性与女性的关系
05:06
on relationships关系 between之间 men男人 and women妇女.
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也是个有意思的题目。
05:09
One intriguing奇妙 possibility可能性
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一个有趣的可能性
05:10
is that a man could monitor监控
his contraceptive避孕的 status状态 over time.
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是男性可以随时监测
自己的避孕状态。
05:15
In the last several一些 years年份,
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在过去的几年里,
05:17
two groups have introduced介绍
home sperm-testing精子检测 devices设备
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两组人员引入了
家用的精子测量设备,
05:21
that are iPhone-based基于 iPhone 的
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这些设备基于 iPhone,
05:23
and that are easy简单 to use.
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并且很容易使用。
05:25
A man could test测试 his sperm精子 count计数
and share分享 the result结果 with his partner伙伴.
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男性可以测量自己的精子数量,
并把结果分享给自己的伴侣。
05:29
If the man's男人的 sperm精子 count计数 were zero,
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如果他的精子量为零,
05:31
the man and his partner伙伴
would feel very comfortable自在
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那他和他的伴侣就可以很安心的
05:34
relying依托 on his contraceptive避孕的.
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依靠他的避孕药避孕。
05:37
A tool工具 like this,
coupled耦合 with a male contraceptive避孕的,
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像这样的工具,加上男性避孕药,
05:40
could greatly非常 increase增加 the role角色 for men男人
in preventing防止 unintended意外 pregnancy怀孕.
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可以大大增加男性在
预防意外怀孕中的作用。
05:46
The researchers研究人员 who are working加工
on male contraception避孕
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研发男性避孕药的研究人员
05:49
are trying to create创建
a better future未来 for couples情侣,
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正在尝试为伴侣创建更美好的未来,
05:52
a future未来 where contraception避孕 is no longer
considered考虑 just "a woman's女人的 issue问题,"
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一个避孕不再只是“女性的问题”,
05:57
rather an issue问题
for couples情侣 to decide决定 together一起.
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而是由伴侣双方一起决定的未来。
06:01
So why does the world世界 need a male pill?
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所以说,为什么
世界需要男性避孕药?
06:04
Well, I believe that a male pill
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因为我相信男性避孕药
06:06
will help reduce减少 the stubbornly固执地 high
rates利率 of unintended意外 pregnancy怀孕 and abortion流产
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可以帮助降低总是居高不下的
意外怀孕和堕胎的比率,
06:12
and allow允许 men男人 to equally一样 participate参加
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让男性可以平等的参与避孕。
06:15
in contraception避孕.
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06:17
Thank you.
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谢谢!
06:18
(Applause掌声)
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(掌声)
Translated by Christina Wang

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ABOUT THE SPEAKER
John Amory - Male reproductive health expert
John Amory is leading research into novel options for male contraception, male infertility and hypergonadism.

Why you should listen

John Amory is is currently examining the potential of using inhibitors of testicular retinoic acid biosynthesis as reversible male contraceptives. He has published more than 130 peer-reviewed papers in the field of male reproduction and serves on the Advisory Board of the Male Contraception Initiative. He is currently Professor of Medicine and Section Head of General Internal Medicine at the University of Washington, where he works as an attending physician on the inpatient medicine wards and in the outpatient General Internal Medicine and Men's Health Clinics.

More profile about the speaker
John Amory | Speaker | TED.com